Clinical Studies on Spondylolisthesis
10.4055/jkoa.1976.11.1.1
- Author:
Byeong Mun PARK
;
In Hee CHUNG
;
Hak Yoon OH
- Publication Type:Original Article
- MeSH:
Braces;
Early Ambulation;
Female;
Follow-Up Studies;
Humans;
Immobilization;
Laminectomy;
Low Back Pain;
Lumbar Vertebrae;
Male;
Methods;
Return to Work;
Sciatica;
Spine;
Spondylolisthesis;
Transplants;
Young Adult
- From:The Journal of the Korean Orthopaedic Association
1976;11(1):1-10
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Spondylolisthesis is characterized by forward displacement of the vertebral body with bilateral defects of the partes interarticulares. Because the progression of slipping occurs in young adults, difficult problems are present in the treatment of this condition. Watkins(1953) described the technique of posterolateral fusion between transverse processes, which was accepted in the dynamics of spine motion. In this procedure, grafted bone is placed close to the center of axis of the spine motion and so, bony fusion is not affected by flexion motion but distracted by a Iateral shearing force. The role played by the Norton-Brown back brace is in the restriction of lateral bending. However it pormits somewhat flexion motion of the spine. It is suggested that early ambulation may be possible without the interference of bony union after the posterolateral fusion operation when this brace is applied instead of longterm cast immobilization. In clinical analyses and follow-up studies after operative treatments in 55 patients with spondylolisthesis, the following results were obtained: 1. 30 patients (54.6%) were distributed between 21 and 40 years of age. 2. Males (52.7%) were slightly more than females (47.3%). 3. Among clinical symptoms and signs, low back pain was most common (87.3%). Sciatica was present in 45.5% 4. Duration of symptoms at admission was variable. 5. 15 patients (27.3%) had a previous history of trauma. 6. 5th lumbar vertebra was most commonly involved (74.5%) followed by the 4th lumbar vertebra(23.6%). There was a case(1.9%) in which the 5th and 4th lumbar vertebrae were involved. 7. Degrees of slipping were divided into 4 grades (Grade I–IV) by Meyerdings method. Grade 1 was most common (72.2%), Grade II 22.2% and Grade III 5.6%. 8. In follow-up studies of the operative treatment, laminectomy & H-graft were satisfactory in 84.9% and posterolateral fuion in aII cases (13 patients). 9. Early ambulation was preferred without healng disturbance in a case in which the Norton-Brown back brace was applied after posteroIateraI fusion and also, other advantages were expected as follws: a) Elimination of prolonged cast immobiIization b) Financial aid c) Early return to work d) Mental comfort.
